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Emerging adults with high levels of inhibited personality traits may be at-risk for drinking to cope during the COVID-19 pandemic. The current research explored mediational pathways between two inhibited personality traits (anxiety sensitivity (AS) and hopelessness (HOP)), internalizing symptoms (anxiety, depression, and COVID-19 distress), and coping drinking motives (drinking to cope with anxiety and drinking to cope with depression) during the pandemic. Cross-sectional data were collected from 879 undergraduate drinkers (79% female, 83% White, 18-25 years old) at five Canadian universities from January-April 2021. Participants self-reported on their personality, anxiety (GAD-7), depressive symptoms (PHQ-9), COVID-19 distress, and coping drinking motives. Mediational path analyses provided evidence of both specific and non-specific pathways between personality and coping motives via internalizing symptoms. Depressive symptoms partially mediated the link between HOP and drinking to cope with depression motives. While anxiety symptoms did not significantly mediate links between AS and coping with anxiety motives in the full model, evidence of mediation was found in a post-hoc sensitivity analysis. COVID-19 distress served as a non-specific mediator. AS and HOP are critical transdiagnostic risk factors that increase vulnerability for internalizing psychopathology and, in turn, risky drinking motives, in the context of the COVID-19 pandemic.

We investigated whether anxiety sensitivity (AS) is associated with increased distress and adherence to public health guidelines during the COVID-19 pandemic among undergraduates, and whether increased distress mediates the relationship between AS and increased adherence. An online cross-sectional survey was conducted with 1318 first- and second-year undergraduates (mean age of 19.2 years; 79.5% females) from five Canadian universities. Relevant subscales of the Substance Use Risk Profile Scale (SURPS) and the Big Five Inventory-10 (BFI-10) were used to assess AS and neuroticism. Three measures tapped distress: the Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms, the Generalized Anxiety Disorder-7 (GAD-7) for anxiety symptoms, and the Brief COVID-19 Stress Scales (CSS-B) for COVID-19-specific distress. The COVID-19 Adherence scale (CAD) assessed adherence to COVID-19 containment measures. AS was significantly independently associated with higher general distress (both anxiety and depressive symptoms) and higher COVID-19-specific distress, after controlling age, sex, study site, and neuroticism. Moreover, AS indirectly predicted greater adherence to COVID-19 preventive measures through higher COVID-19-specific distress. Interventions targeting higher AS might be helpful for decreasing both general and COVID-19-specific distress, whereas interventions targeting lower AS might be helpful for increasing adherence to public health containment strategies, in undergraduates.

Background: This study investigated the relationship between menstrual hygiene practices and academic performance among rural Bangladeshi adolescent girls. Methods: A cross-sectional survey was carried out among the 499 secondary-school-going adolescent girls in grades 7–10 (aged 11–17 years, mean ± SD = 14.04 ± 1.11 years) attending either public or private institutions in rural Bangladesh. Menstruation hygiene management (MHM) was defined based on three indicators such as (i) change materials (pads/cloths) less than every 6 h, (ii) hand washing practice with soap before and after changing pads/cloths, or not washing the external genitalia at least once per day, and (iii) using a sanitary pad or drying of re-usable cloths under direct sunlight. The MHM was categorized as poor (if not practicing or practicing only one issue), average (if practicing only two issues), or good (if practicing all of the issues). School performance was determined by the total marks obtained in their last final examination (&lt, 60% marks defined as low performance and ≥60% marks defined as good performance). Binary logistics regression models were developed at the &lt, 0.05 significance level. Results: The mean age of the participants was 12 years, where 83% reported a regular menstrual cycle pattern. Overall, prevalence of practicing poor, average, and good MHM were found to be 28.46%, 55.71%, and 15.83%, respectively. About 52% of girls reported using sanitary napkins (manufactured disposable pads), 43.4% reported using pieces of reusable cloths per occasion (multiple uses), and almost all (96.29%) reported using detergents to clean multiple-use cloths. We found 2.9 times (AOR: 2.90, 95% CI: 1.61–5.24) and 5.7 times (AOR: 5.65, 95% CI: 2.72–11.71) higher odds to achieve good academic performance among those who practiced ‘average’ and ‘good’ MHM after adjusting age, education, paternal education, occupation, maternal education, household wealth status, and respondent’s knowledge of menstruation. Conclusions: Results suggested that girls’ school academic performance can be improved by practicing good menstrual hygiene practices. School-based menstrual hygiene management education could be useful.

Objective Cannabis is commonly used by Canadian emerging adults (ages 18–25 years), many of whom attend post-secondary institutions. Frequent cannabis use is linked with psychotic-like experiences (PLEs); however, the exact nature of this association remains unclear. Anxiety symptoms may mediate this association, as they are prevalent in emerging adults and have been independently linked with both cannabis use and PLEs. Past work found that anxiety mediated the association between cannabis use frequency and attenuated positive psychotic symptoms (further along the psychosis continuum than PLEs), however this research had yet to be validated in the Canadian population, and trait rather than state anxiety (frequency of anxiety symptoms) was studied. Thus, our primary objective was to examine if anxiety symptoms mediated the association between cannabis use frequency and PLEs in Canadian emerging adult undergraduates. Despite known sex differences in cannabis use, expression of anxiety, and PLEs, past work did not evaluate the potential impact of biological sex on the anxiety-mediated model, and thus is the secondary objective of the present study. Methods 1,266 first-/second-year emerging adult undergraduates from five Canadian universities provided cross-sectional, self-report survey data in fall 2021 semester. Validated measures of cannabis use frequency, anxiety, and PLEs were administered. Results Path analyses supported mediation from cannabis use to PLEs through anxiety ( b = 0.07, P Conclusions Anxiety symptoms mediated the association between cannabis use and PLEs in emerging adults regardless of their biological sex. Assuming replication in prospective research, results highlight anxiety as an important intervention target in frequent cannabis-using emerging adults, to potentially prevent development/worsening of PLEs, and in turn psychotic illness.

The study aimed to assess the prevalence and factors associated with knowledge and use of the emergency contraceptive pill (ECP) among ever-married women in Bangladesh.The study was based on a secondary dataset of the 2014 Bangladesh Demographic and Health Survey. Complete (weighted) data of 17,592 women aged 15-49 years were analysed.The prevalence of having knowledge and use of the ECP among ever-married women in Bangladesh was 13.6% and 1.8%, respectively. Administrative region and type of residence (urban or rural), household wealth index, educational level (of both the woman and her spouse), spouse's occupation, number of living children, weight, current use of contraception and a history of pregnancy termination were positively associated with knowledge and use of the ECP.A large proportion of Bangladeshi women of reproductive age had a lack of knowledge and use of the ECP. Nationwide reproductive health education programmes may improve the situation.

BRAC Bangladesh trains community health workers to communicate about nutrition in its Maternal, Newborn and Child Health programme. We estimate the programme’s impact on nutrition outcomes among ru...

Over the past two decades, there has been a global rise in the prevalence of waterpipe tobacco smoking. Waterpipe tobacco smoking involves the inhalation of heated tobacco smoke after passing through water, and it has been associated with an identified dependence effect similar to that found with cigarette smoking. Despite the popularity of waterpipe tobacco among youth (and in particular, university students) in many countries, detailed data of its usage are lacking in Bangladesh. Therefore, the present study was conducted to explore waterpipe tobacco smoking behavior and normative beliefs among university students in Bangladesh and to assess the factors associated with waterpipe tobacco use. A quantitative cross-sectional survey was carried out among 340 Bangladeshi university students (64.4% male; mean age 21.6 years). Among participants, 13.5% reported they had ever smoked tobacco from a waterpipe and 9.4% had it in past 30 days. Among past 30-day users, 72% were categorized as having waterpipe smoking dependence (n = 23). No females in the sample had ever smoked using a waterpipe. Maternal occupation, monthly expenditure, and regular smoking status were major predominant factors associated with waterpipe smoking behavior of the students. The study is of existential value given that there are no prior studies ever carried out in Bangladesh previously. Recommendations are provided based on the study’s findings, particularly in relation to what action is needed from universities in Bangladesh.

The early initiation of breast-feeding (EIBF) within 1 h of birth, exclusive breast-feeding (EBF) to 6 months and continued breast-feeding (CBF) to 2 years are key infant and young child feeding guidelines promoted globally for optimal child health and development. Using publicly available national survey data from the five most recent, consecutive Bangladesh Demographic and Health Surveys (2004, 2007, 2011, 2014 and 2017–2018), we assessed the trends in these key breast-feeding indicators. Multiple multilevel logistic regression models were built to assess socio-demographic predictors of breast-feeding using the latest 2017–2018 data set. Both EIBF and EBF have increased significantly between 2004 and 2017–2018, from 26 % to 60 % and 36 % to 68 %, respectively, and CBF decreased from 94 % to 85 %. Caesarean section delivery conferred lower EIBF practice (OR = 0·34, 95 % CI 0·27, 0·42) compared with vaginal delivery. Women who were currently working had 32 % lower odds of EBF (OR = 0·68, 95 % CI 0·48, 0·95). Compared with delivery at home, women who delivered in a health facility had 81 % higher odds of EBF (OR = 1·81, 95 % CI 1·25, 2·34). Larger family size (≥5) also predicted EBF (OR = 1·70, 95 % CI 1·21, 2·40). Rural residency was associated with 2·39 (95 % CI 1·32, 4·31) times of higher odds of CBF. Regional variation was also predictive of the various breast-feeding indicators. Although Bangladesh currently exceeds the 2019 global prevalence rates for these three breast-feeding indicators, efforts should be made to continue improving EIBF and EBF and to prevent future decreases in CBF.

Purpose: To identify and compare important risk and protective factors associated with suicidality and self-harm among traditional bullying and cyberbullying victims aged 14-17-years in Australia. Design: Cross-sectional population-based study. Setting: Young Minds Matter, a nationwide survey in Australia. Subjects: Adolescents aged 14-17-years (n = 2125). Measures: Suicidality and self-harm were outcome variables, and explanatory variables included sociodemographic factors (age, gender, country of birth, household income, location, family type), risk factors (parental distress, family functioning, family history of substance use, child substance use, mental disorder, psychosis, eating disorders, sexual activity) and protective factors (high self-esteem, positive mental health or resilience, school connectedness, sleep) among 2 types of bullying victims—traditional and cyber. Traditional bullying includes physical (hit, kick, push) or verbal (tease, rumors, threat, ignorance), and cyberbullying includes teasing messages/pictures via email, social medial using the internet and/or mobile phones. Analysis: Bivariate analysis and binary logistic regression models. Statistical metrics include Hosmer-Lemeshow Goodness-of-Fit-test, VIF test, Linktest and ROC curve for model performance and fitness. Results: Overall, 25.6% of adolescents were traditional bullying victims and 12% were cyberbullying victims. The percentages of suicidality (34.4% vs 21.6%) and self-harm (32.8% vs 22.3%) were higher in cyberbullying victims than in traditional bullying victims. Girls were more often bullied and likely to experience suicidal and self-harming behavior than boys. Parental distress, mental disorder and psychosis were found to be significantly associated with the increase risk for self-harm and suicidality among both bullying victims (p < 0.05). While, eating disorder and sexual activity increased the risk of suicidality in traditional bullying victims and self-harm in cyberbullying victims, respectively. Positive mental health/resilience and adequate sleep were found be significantly associated with decreased suicidality and self-harm in both bullying victims. Conclusion: Suicidality and self-harm were common in bullying victims. The findings highlight that the risk and protective factors associated with suicidality and self-harm among adolescent who experienced traditional and cyberbullying victimization should be considered for the promotion of effective self-harm and suicide prevention and intervention programs.

OBJECTIVES: Iron deficiency (ID) and iron deficiency anaemia (IDA) remain a public health concern among women and girls globally, and have numerous impacts on health, nutrition and socioeconomic status. Our objective was to investigate the efficacy of consuming iron-fortified lentils on iron status among rural Bangladeshi adolescent girls. METHODS: In this community-based, double-blind, cluster-randomized controlled trial, girls (13.5 ± 2.0 years) were randomly assigned to three groups that received 1)cooked iron-fortified lentils (160 ppm Fe NaFeEDTA per kg of lentils); 2)cooked non-iron-fortified lentils; or 3)no lentils (usual intake group). We served 200 g of cooked lentils using a local daal recipe on five days/week, for 4 months. Iron status (sFer, sTfR, and Hgb) was assessed at baseline, 2 and 4 months. All analyses were adjusted for inflammation. RESULTS: There were no differences in baseline iron status among the three groups. sFer significantly increased by 21.9% (+5.7 μg/L, p

Background Ensuring water, sanitation, and hygiene (WASH) facilities for households remains a major public health concern in low- and middle-income countries (LMICs). This study investigated the current situation of basic WASH facilities for households in Bangladesh and drew a national coverage map. Methods We analyzed the publicly available nationally representative 2019 Multiple Indicator Cluster Survey (MICS) dataset that was carried out by the Bangladesh Bureau of Statistics (BBS) with support from the United Nations Children’s Emergency Fund (UNICEF). A total of 61,209 households (weighted) were included in the analysis. Both bivariate and multivariate analyses were employed to examine the relationships between independent variables (socio-demographic and economic status) and their distributions over outcome variables (basic water, sanitation, and hygiene). Further, the spatial distribution of WASH facilities at the household level was depicted. Results Coverage of access to basic water facilities at the household level was 99.5% (95% CI 99.4% to 99.6%), sanitation 60.7% (95% CI 60.0% to 61.5%), and hygiene 56.3% (95% CI 55.6% to 57.0%). However, coverage of combined access to all three components was 40.2% (95% CI 39.4% to 40.9%). Among all 64 administrative districts of Bangladesh, we found comparatively lower coverage of WASH facilities in the South and South-East regions and relatively higher in the households of the North and North-Western regions. An adjusted regression model revealed that richest households [AOR = 29.64, 95% CI 26.31 to 33.39], households in the rural areas [AOR = 1.64, 95% CI 1.50 to 1.79], household heads with higher educational attainment [AOR = 2.28, 95% CI 2.09 to 2.49], and households with 5+ family members [AOR = 1.64, 95% CI 1.56 to 1.71] had the higher likelihood to have basic WASH facilities. Conclusion Less than half of the Bangladeshi households had access to all three major WASH components (basic water, sanitation, and hygiene facilities); however, variation exists at the individual parameter of basic water, sanitation, and hygiene facilities. A comprehensive WASH approach may reduce the gap and improve the quality of WASH facilities in Bangladesh.

Objective: The main objective of the present study was to investigate the association of risk factors on sleep quality of Bangladeshi university students.\ud \ud \ud Method: A total of 332 students participated in a cross-sectional structured interview study.\ud \ud \ud Result: Utilizing the Pittsburgh Sleep Quality Index, the overall prevalence of poor sleep quality among the students was 66.6%, and the prevalence was higher among the female students (81.4%). Females had a 4.1 times higher risk of having poor sleep quality (AOR = 4.12, 95% CI 2.15–7.86, p

The objective of the study was to assess the prevalence and factors associated with household (HH) handwashing practice in Bangladesh and draw a trend of COVID-19 spreads and compare that with the countrywide HH handwashing practice. The study is based on the two national representative publicly available datasets (MICS 2019, and confirmed cases of COVID-19). Of 61,209 (weighted) HH, the overall prevalence of HH handwashing was found 56.3%, and the prevalence was significantly varied across the socio-economic status of the HH. Map comparison suggested that the gradual increasing trend of COVID-19 cases in areas where HH handwashing practice is low. The northern part of Bangladesh had the highest handwashing practice, whereas it had less effected by COVID-19 cases. However, central Bangladesh had the hardest hit by COVID-19 cases, and it had around 50% handwashing practice coverage. Large-scale observational study is necessary to establish the causality.

This study evaluated the sensory properties of uncooked and cooked milled lentils that were fortified with varying concentrations of Fe and Zn in the form of NaFeEDTA and ZnSO4.H2O, respectively. Our study was carried out among 196 lentil consumers residing in rural Bangladesh who experience with growing, processing, and marketing lentils. A nine-point hedonic scale was used to rate the appearance, odor, taste, texture and overall acceptability of three uncooked and two cooked lentil (dal) samples made from each of the three milled lentil product types (LPTs), red football, red split and yellow split. Preferences for sensory properties were found to be significantly different among all uncooked lentil samples, but not significantly different for cooked samples, with a few exceptions. This means that the fortification process minimally affects dual-fortified lentil sample (fortified with 16 mg of Fe and 8 mg of Zn per 100 g of lentil), which was compared to another cooked sample (unfortified control), in terms of consumers liking for all four attributes (appearance, odor, taste, and texture).

Background: The newly identified Coronavirus disease (COVID-19) has currently expanded and shifted from an epidemic to global pandemic. To date there is no proven vaccine for this contagion, prevention measures are the only option for the world to stay safe. According to the World Health Organization, frequent handwashing with soap for 20 seconds is the most effective prevention measures to reduce the incidence of this global pandemic. Method: Our present study was based on the national presentative publicly available two datasets. One is the latest Multiple Indicator Cluster Survey (MICS 2019) to explore hand washing situation in Bangladesh, another one is the confirmed cases of COVID-19 throughout Bangladesh from Institute of Epidemiology, Disease Control and Research (IEDCR), Bangladesh as of June 20, 2020. Both data were cross-sectional in nature. Findings: Prevalence of household handwashing was found 56.3%, and the prevalence was significantly varied across the socio-economic status of the households (HH). We observed a higher number of COVID-19 cases (as of June 20, 2020) where there is a relatively lower prevalence of handwashing. Northern part of Bangladesh had the highest handwashing practice whereas it had less effected by COVID-19 cases. However, central Bangladesh had the hardest hit by COVID-19 cases, and it had around 50% handwashing practice coverage. Poorer HHs, low education of the HH heads, HH with no improved water source facility had a strong correlation with not practicing HH handwashing. Interpretation: Around half of Bangladesh does not practice HH level handwashing. Areas where higher the HH handwashing practice, lower the COVID-19 cases were observed. Funding Statement: Authors did not receive any funding for this study. Declaration of Interests: The authors have no conflict of interest to declare.

Background Research supports a robust association between bullying, mental disorder, self-harm, and suicidal ideation in adolescence; however, the relation between bullying victimization and access to mental health services is incompletely understood. This study investigated whether traditional and cyberbullying victimization were associated with access to mental health services in adolescents, and to test the interaction between bullying victimization with a mental disorder, self-harm, and suicidal ideation on each service. Methods Data analyses were conducted on 2218 Australian adolescents aged 12–17 years using the Young Minds Matter survey. Binary logistic regression models were employed to assess the odds of using mental health services (health, school, telephone, and online) separately among traditional bullying and cyberbullying victims. Interaction terms – ‘bullying victimization and mental disorder’, ‘bullying victimization and self-harm’, and ‘bullying victimization and suicidal ideation’, – were included in the regression models to examine whether and to what extent service use is affected respectively among traditionally bullied and cyberbullied sample. Results Overall, 27.6% and 11.2% of adolescents experienced traditional bullying and cyberbullying, respectively. Also, the percentages of any mental disorder (20.4%) and health-risk behaviours (self-harm − 7.6% and suicidal ideation − 8.3%) were significant among the sample. Although many bullying victims did not use any services, both bivariate and multivariate analyses showed a strong and significant association between bullying victimization (traditional and cyber) and access to mental health services. Adolescents who reported both traditional bullying victimization and self-harm were found to be significantly associated with school service (p Conclusion A limited number of bullying victims with or without mental health problems (mental disorder, self-harm, and suicidal ideation) use mental health services. Further research is warranted to identify the barriers to service use and to promote service utilization in adolescent bullying victims in a way that prevents the effects of bullying timely.

To investigate the association of total sleep time and presence or absence of snoring with chronic disease among the Bangladeshi adult population.Cross-sectional survey.Urban and rural Bangladesh.A total of 12,338 men and women aged ≥35 years.Total sleep time was considered as the total hours of sleep in 24 hours. Furthermore, sleep time was categorized into7, 7-9, and9 hours according to National Sleep Foundation (2015) guidelines. Self-reported snoring history was captured and corroborated with their respective sleep partner/spouse in more than 80% cases. Registered physician-diagnosed current and/or previous cases of hypertension, diabetes, coronary heart disease, cancer, stroke, chronic obstructive pulmonary disease, and any other chronic conditions were counted.Overall prevalence of at least 1 chronic disease in our study population was around 18%: men (15.4%) and women (20.0%). Hypertension has the highest prevalence (overall: 12.7%, men: 12.2%, women: 15%) followed by diabetes (4.9%), coronary heart diseases (3.2%), stroke (1.8%), chronic obstructive pulmonary disease (0.9%), and cancer (any type: 0.1%). Sleep pattern and snoring are significantly associated with all individual chronic disease except cancer. Sociodemographic, behavioral, and lifestyle variables were adjusted, and inadequate total sleep time (7 hours) and snoring (yes/no) showed significant association with chronic disease status (risk ratio = 1.11, 95% confidence interval 1.00-1.22 and risk ratio = 1.20, 95% confidence interval 1.11-1.29, respectively).Inadequate sleep and snoring are independently associated with chronic disease in Bangladeshi adult population and perhaps elsewhere.

Objectives We calculated the prevalence of reproductive health services utilization among the currently married non-pregnant women in Bangladesh and investigated its association with demographics and socio-economic factors. Methods Publicly available secondary country representative 2019 Multiple Indicator Cluster Survey (MICS) dataset was analyzed. A two-stage stratified random sampling technique was followed, and all administrative districts (N=64) of Bangladesh were covered in the MICS 2019. Contraceptive use, antenatal care and skilled birth attendant were considered as utilization of reproductive health services and both crude and adjusted Odd Ratio (OR) were reported using a total of 8917 (weighted) data. Results In Bangladesh, 36.9% of married non-pregnant women utilized all three reproductive health services. However, at disaggregated level, contraceptive use (66.9%), antenatal care (83%) and skilled birth attendant (59.3%) were found 2-3 folds higher then cumulative prevalence. Increased likelihood of utilization of reproductive health services (either combined or at individual services) was observed among those women who had higher education [AOR= 2.63, 95% CI 1.99 to 3.47], belong to wealthy families [AOR= 2.46, 95% CI 1.94 to 3.12], residing in urban areas [AOR= 1.33, 95% CI 1.14 to 1.54], having a smaller number of children [AOR= 1.53, 95% CI 1.25 to 1.87], and exposure to media [AOR= 1.44, 95% CI 1.26 to 1.63]. Conclusion Around one-third of Bangladeshi married women received combined contraceptive use, antenatal care and skilled birth attendant reproductive health services; however, variation exist at the individual service level. Targeted public health campaign focusing on women education and media advertisement may increase the utilization.

Child malnutrition is indisputably a multi-faceted phenomenon. Comprehending the aforesaid crucial issue this paper intended to identify climatic and non-climatic factors for the spatial variation of malnutrition prevalence in Bangladesh. The climatic data on temperature and rainfall are obtained from the WorldClim dataset. We obtained a set of global climate layers that included monthly data on minimum temperature, maximum temperature, mean temperature, and rainfall for the period 1960–1990, at a spatial resolution up to 30 ′onds (~ 1 × 1 km at the equator). The data are extracted at the district level using the zonal-statistics in QGIS. This study performed a spatial lag regression to evaluate association of malnutrition with climate characteristics and other factors. The prevalence of malnutrition exhibited substantial association with temperature and precipitation. Food production, water access, improved sanitation, literacy, road density, solvency ratio and GDP had a significant association with the spatial variation of malnutrition in Bangladesh.

Given the targeted 4–5% annual reduction of tuberculosis (TB) cure cases to reach the “End TB Strategy” by 2020 milestone globally set by WHO, exploration of TB health seeking behavior is warranted for insightful understanding. This qualitative study aims to provide an account of the social, cultural, and socioeconomic breadth of TB cases in Bangladesh. We carried out a total of 32 In-depth Interviews (IDIs) and 16 Key Informant Interviews (KIIs) in both rural and urban areas of Bangladesh. We covered both BRAC [a multinational Non-governmental Organization (NGO)] and non-BRAC (other NGOs) TB program coverage areas to get an insight. We used purposive sampling strategy and initially followed “snowball sampling technique” to identify TB patients. Neuman’s three-phase coding system was adopted to analyze the qualitative data. Underestimation of TB knowledge and lack of awareness among the TB patients along with the opinions from their family members played key roles on their TB health seeking behavior. Quick decision on the treatment issue was observed once the diagnosis was confirmed; however, difficulties were in accepting the diseases. Nevertheless, individual beliefs, intrinsic ideologies, financial abilities, and cultural and social beliefs on TB were closely inter-connected with the “social perception” of TB that eventually influenced the care seeking pathways of TB patients in various ways. Individual and community level public health interventions could increase early diagnosis; therefore, reduce recurrent TB.

Lipoprotein(a)-cholesterol (Lp(a)-C), a low-density lipoprotein (LDL)-like particle is considered as a risk factor for cardiovascular diseases (CVDs). We aimed to investigate the association of Lp(a)-C expression with dyslipidemia among the Bangladeshi population and assess the relationship with cardiovascular risks. In this cross-sectional comparative study, a total of 180 urban males and females between ages 19-65 years were included who were enrolled in a hospital setting of Bangladesh. Participants were selected based on their total cholesterol (TC) level≥200 mg/dl, high density lipoprotein (HDL)-C Further, participants’ socio-demographics and body mass index (BMI) were collected. Expression of Lp(a)-C was detected in 22.86% patients with desirable levels (

Widely consumed daal (lentils) in Bangladesh are an ideal vehicle for iron (Fe) fortification, however, an acceptable portion size in meals needs to be determined to carry out a community feeding study in at-risk adolescent girls. A non-randomized crossover trial was conducted with n = 100 Bangladeshi girls (12.9 ± 2.0 years of age). Two recipes (thin and thick) and three portion sizes (25 g, 37.5 g, 50 g of raw lentil) of daal were served with 250 g of cooked white rice in a counter-balanced manner over 12 weeks. Each meal was fed to participants 5 days/week for two weeks. Ratings of hunger, satiety, and palatability were measured before and after each meal using Visual Analog Scales (VAS). The thick preparation in the 37.5 g portion (~200 g cooked) elicited higher VAS ratings of hunger, satiety, and palatability compared to all other meals. The 50 g portion of the thin preparation had VAS ratings similar to those of the 37.5 g thick preparation. Consuming the 37.5 g portion of fortified daal would provide 6.9 mg Fe/day to girls in a community-based effectiveness study. This would meet ~86% and ~46% of the Recommended Dietary Allowance (RDA) for Fe for girls aged 9–13 and 14–18 years, respectively.

Bangladesh is suffering from a higher burden of childhood mortality and morbidity. However, data on healthcare seeking behavior for illness, particularly among the children, is lacking. The objectives of our study were to assess the prevalence and factors associated with healthcare seeking behavior for diarrhea and fever or cough among Bangladeshi children. We used the most recent data of Bangladesh Multiple Indicator Cluster Survey (MICS) 2019. Our study included children aged 0–59 months who had diarrhea, fever/cough in the two weeks preceding the survey. A two-stage stratified cluster sampling method drawn from a nationally representative sample. The study found that 28.0% and 25.6% of the children suffering from diarrhea and fever/cough sought formal healthcare services during illness. Children’s age (0 – 11 months), and maternal education (higher secondary +) were identified as the common predictors of formal healthcare seeking behavior for diarrhea and fever/cough. Ensuring the availability and accessibility of health facilities and various health education programs can contribute in this regard.

This study investigated total sleep time in the Bangladeshi population and identified the proportion of the population at greater risk of developing chronic diseases due to inadequate sleep. Using a cross-sectional survey, total sleep time was captured and analysed in 3968 respondents aged between 6 and 106 years in 24 (of 64) districts in Bangladesh. Total sleep time was defined as the hours of total sleep in the previous 24 h. We used National Sleep Foundation (2015) guidelines to determine the recommended sleep hours in different age categories. Less or more than the recommended total sleep time (in hours) was considered 'shorter' and 'longer' sleep time, respectively. Linear and multinomial logistic regression models were used to determine the relationship between demographic variables and estimated risk of shorter and longer total sleep time. The mean (±standard deviation) total sleep time of children (6-13 years), teenagers (14-17 years), young adults and adults (18-64 years) and older adults (≥65 years) were 8.6 (±1.1), 8.1 (±1.0), 7.7 (±0.9) and 7.8 (±1.4) h, respectively, which were significantly different (P 0.01). More than half of school-age children (55%) slept less than, and 28.2% of older adults slept longer than, recommended. Residents in all divisions (except Chittagong) in Bangladesh were less likely to sleep longer than in the Dhaka division. Rural populations had a 3.96× greater chance of sleeping for a shorter time than urban residents. The Bangladeshi population tends to sleep for longer and/or shorter times than their respective recommended sleep hours, which is detrimental to health.

ObjectiveChildhood stunting remains a major public health concern in Bangladesh. To accelerate the reduction rate of stunting, special focus is required during the first 23 months of a child’s life when the bulk of growth takes place. Therefore the present study explored individual-, maternal- and household-level factors associated with stunting among children under 2 years of age in Bangladesh.DesignData were collected through a nationwide cross-sectional survey conducted between October 2015 and January 2016. A two-stage cluster random sampling procedure was applied to select 11 428 households. In the first stage, 210 enumerations areas (EA) were selected with probability proportional to EA size (180 EA from rural areas, thirty EA from urban slums). In the second stage, an average of fifty-four households were selected from each EA through systematic random sampling.SettingRural areas and urban slums of Bangladesh.ParticipantsA total of 6539 children aged 0–23 months.ResultsOverall, 29·9 % of the children were stunted. After adjusting for all potential confounders in the modified Poisson regression model, child’s gender, birth weight (individual level), maternal education, age at first pregnancy, nutrition (maternal level), administrative division, place of residence, socio-economic status, food security status, access to sanitary latrine and toilet hygiene condition (household level) were significantly associated with stunting.ConclusionsThe study identified a number of potentially addressable multilevel risk factors for stunting among young children in Bangladesh that should be addressed through comprehensive multicomponent interventions.

Background Anemia is a significant wide spread public health threat especially among the adolescent girls who are more vulnerable towards low level of hemoglobin particularly of low and middle income countries (LMICs). We investigated the prevalence of anemia among the adolescent girls (10–19 years) in Bangladesh and its socio-demographics distribution. Methods We collected data digitally in ODK platform from a sub-sample of a nationwide cross-sectional survey of 1314 adolescent girls in 2015. Capillary blood hemoglobin level was estimated using HemoCue®; anthropometric measurements through standardized procedure and details socio-demographic information were captured and analyzed. Malnutrition was defined as BMI-for-age Z-score below -2SD (BAZ

It is evident that arsenic has detrimental effect on health including deadlier disease such as cancer, diabetes mellitus, birth defects which can eventually lead to adverse effect on our social life. Over the last 40 years, several research on arsenic epidemiology and public health carried out in Bangladesh to ratify its adverse effect on our health and social life. However, most of these researches focused on the extent of arsenic contamination in groundwater and related health consequences. Lack of comprehensive matrix lead us to compile all published arsenic research articles that had been undertaken in Bangladesh during Millennium Development Goals (MDGs) period (2000–2015) focused on the recommendation of arsenic mitigation and technologies, and future direction. Review matrix was developed in three different categories (1) Policy level (2) Facilities and technologies and (3) Health system, as these categories were the key areas to mitigate arsenic exposure. We noted mixed policy recommendations, and of those, incoordination among different stakeholders came up as one of the key barriers for arsenic mitigation in Bangladesh. Sharing low or arsenic-free tubewell, proper use and maintenance of arsenic filters, structural supply water such as the pipe water and pay-per-use concept were highlighted in several research. Women should be actively involved in all mitigation programs in Bangladesh.

OBJECTIVES: Despite all efforts, iron deficiency (ID) and iron deficiency anaemia (IDA) among adolescent girls remains a public health concern for Bangladesh. The objective of the current analysis was to examine baseline data from an effectiveness trial with the aim to compare prevalence of anemia, ID and IDA with Bangladesh's National Micronutrients Status Survey 2011–12. METHODS: A community-based, double-blind, cluster randomized controlled trial is being conducted among n = 1260 Bangladeshi adolescent girls (10–17 years). Treatment groups include: 1) Fe-fortified lentils; 2) unfortified lentils and 3) usual intake (no intervention). Within the lentil groups, participants are being served 250 g cooked lentils with half a cup of cooked rice 5 days/week for 85 feeding days. All Fe-fortification and processing of lentils were carried out at the University of Saskatchewan. Anemia, ID and IDA were defined according to WHO (2011) cut-off values. RESULTS: At baseline, age of participants was 13.5 ± 2.0 years; BMI 18.2 ± 3.0 kg/m2 (or 38th percentile BMI-for-age); hemoglobin 12.4 ± 1.1 g/dL, serum ferritin 54.2 ± 36.3 ng/mL, sTfR 3.7 ± 2.6 µg/mL, and CRP 1.2 ± 3.9 mg/L. 26.6% girls were clinically anemic (non-pregnant-Hb

Background A continuous influx of poor people to urban slums poses a challenge to Bangladesh’s health system as it has failed to tackle maternal morbidity and mortality. BRAC is the largest non-governmental organisation in Bangladesh. BRAC has been working to reduce maternal, neonatal and under-five children morbidity and mortality of slum dwellers in cities. BRAC has been doing this work for a decade through a programme called MANOSHI. This programme provides door-to-door services to its beneficiaries through community health workers (CHWs) and normal delivery service through its delivery and maternity centres. BRAC started the ‘MANOSHI’ programme in Narayanganj City Corporation during 2011 to address maternal, neonatal and child health problems facing slum dwellers. We investigated the existing maternal health-service indicators in the slums of Narayanganj City Corporation and compared the findings with a non-intervention area. Methods This cross-sectional study was conducted during 2012, in 47 slums of Narayanganj City Corporation as intervention and 10 slums of Narsingdi Sadar Municipality as comparison area. A total of 1206 married women, aged 15–49 years, with a pregnancy outcome in the previous year were included for interview. Data on socio-demographic characteristics, reproductive and maternal health-care practices like use of contraceptive methods, antenatal care (ANC), delivery care, postnatal care (PNC) were collected through a structured questionnaire. The chi-square test, Student t test, Mann Whitney U-test, factor analysis and log-binominal test were performed by using STATA statistical software for analysing data. Results The activities of BRAC CHWs significantly improved four or more ANC (47% vs. 21%; p

Objectives We evaluated the impact of the Improving Maternal, Neonatal, and Child Survival (IMNCS) project, which is being implemented by BRAC in rural communities in Bangladesh. Methods Four districts received program intervention i.e. trained community health workers to deliver essential maternal, neonatal, and child healthcare and nutrition services while two districts were treated as comparison group. A quasi-experimental study design (compared before-and-after) was undertaken. Baseline survey was conducted in 2008 among 7200 women followed by end line in 2012 among 4800 women with similar characteristics in the same villages. We evaluated maternal antenatal and post natal checkup, birth plans and delivery, complication and referred cases during antenatal checkup and post natal period, and child health indicators such as birth asphyxia, neonatal sepsis, and its management by the medically trained provider. Findings Increased number (four or more) antenatal visits, skill-birth attended delivery and postnatal visits (three or more) in the intervention group preceding four-year intervention period were observed compare to their counterpart. We noted negative difference-in-difference estimator (-5.0%, P = 0.159) regarding to the all major birth plans i.e. delivery place, birth attendant, and saved money in the comparison areas. Significant reduction of ante-partum and intra-partum complications occurred in the intervention group, contrary complications of such event increased in the comparison areas (-6.3%, P

Arsenic contamination in drinking water has a detrimental impact on human health which profoundly impairs the quality of life. Despite recognition of the adverse health implications of arsenic toxicity, there have been few studies to date to suggest measures that could be taken to overcome arsenic contamination. After the statement in 2000 WHO Bulletin that Bangladesh has been experiencing the largest mass poisoning of population in history, we researched existing literature to assess the magnitude of groundwater arsenic contamination in Bangladesh. The literature reviewed related research that had been initiated and/or completed since the implementation of the Millennium Development Goals (MDGs) under four domains: (1) extent of arsenic contamination; (2) health consequences; (3) mitigation and technologies and (4) future directions. To this means, a review matrix was established for analysis of previous literature based on these four core domains. Our findings revealed that several high-quality research articles were produced at the beginning of the MDG period, but efforts have dwindled in recent years. Furthermore, there were only a few studies conducted that focused on developing suitable solutions for managing arsenic contamination. Although the government of Bangladesh has made its population's access to safe drinking water a priority agenda item, there are still pockets of the population that continue to suffer from arsenic toxicity due to contaminated water supplies.

Mobile money has grown rapidly in the past few years. It has contributed to greater financial inclusion for the poor and unbanked, bringing millions of people into a formal financial system. Despite the increased use of mobile money, little research has focused on non-profits' preparedness to mobile money adoption. This article explores staff perceptions regarding mobile money at a large Bangladeshi non-profit. The objective of the study was to understand staff and clients' opinions about using mobile money specifically focusing on reliability, efficiency, and quality. In this qualitative study, we focused on five projects and conducted a total of 11 focus group discussions and 50 in-depth interviews. We found staffs and clients were amenable to using mobile money. Most people felt that using mobile money could reduce the workload, save time and money, and make life easier for both staffs and clients. However, significant client adoption barriers exist including client literacy and numeracy levels, a lack of national identity cards and challenges obtaining them, poor mobile networks in remote areas and service fees. Some staff also expressed concerns about mobile money posing a threat to their job security. If mobile money is to realize its full potential as a financial inclusion tool for the poor and unbanked, further research is needed on mobile money adoption and implementation obstacles encountered by non-profits.

Background Chronic exposure to arsenic is associated with neoplastic, cardiovascular, endocrine, neuro-developmental disorders and can have an adverse effect on women’s reproductive health outcomes. This study examined the relationship between arsenic skin lesions (a hallmark sign of chronic arsenic poisoning) and age of natural menopause (final menopausal period) in populations with high levels of arsenic exposure in Bangladesh. Methods We compared menopausal age in two groups of women – with and without arsenic skin lesions; and presence of arsenic skin lesions was used as an indicator for chronic arsenic exposure. In a cross-sectional study, a total of 210 participants were randomly identified from two ongoing studies— participants with arsenic skin lesions were identified from an ongoing clinical trial and participants with no arsenic skin lesions were identified from an ongoing cohort study. Mean age of menopause between these two groups were calculated and compared. Multivariable linear regression was used to estimate the relationship between the status of the arsenic skin lesions and age of natural menopause in women. Results Women with arsenic skin lesions were 1.5 years younger (p